A Baltimore judge has approved a $190 million settlement between Johns Hopkins Hospital and more than 8,000 patients of a gynecologist who used tiny cameras to secretly photograph women and girls during examinations.

A union representing 2,000 environmental services and kitchen workers at Johns Hopkins Hospital is in negotiations with the medical institution over workers’ wages after Gov. Martin O’Malley stepped in to stop a planned four-day strike.

A Johns Hopkins Hospital gynecologist accused of secretly videotaping patients wore a pen around his neck that may have been used to conceal a camera, according to the employee who reported the doctor.